What Does Medicare Not Pay For?

What Does Medicare Not Pay For?

Original Medicare covers a considerable portion of your medical expenses. Medicare Part A helps pay for inpatient hospital stays, skilled nursing facilities, hospice care, and even some other home health care. Medicare Part B helps cover outpatient care, doctor’s visits, certain preventive services, and some medical supplies and equipment. However, it is important to know that Medicare doesn’t cover every health care expense or service and can leave gaps in your coverage. Here is a look at what isn’t paid for by Medicare to avoid unexpected medical bills.

Long-Term Care

Medicare usually doesn’t pay for the cost of long-term care. However, it does pay for your stay at a skilled nursing facility if it follows three days of a hospital stay. While Medicare covers the total cost of services for the first 20 days of care, you will be responsible for coinsurance of $185.50/day (in 2021) for days 21 through 100. And you will be responsible for the costs of skilled nursing care that exceeds 100 days.

Personal Care

Medicare usually won’t pay for the cost for personal care services like dressing, bathing, or getting out of bed. Also, Medicare doesn’t cover housekeeping services like a meal delivered to the house or shopping. However, you may be able to get help with custodial care costs if you are eligible for Medicaid.

Dental Care

Original Medicare won’t cover a visit to your dentist for treatment or preventive care. The plan won’t cover dental fillings, cleanings, dentures, or other types of dental devices either. However, Medicare Part A might cover certain dental services that are considered medically necessary.

You may also get some dental coverage through a Medicare Advantage Plan.

Routine Eye Examinations

Eye examinations for the aim of recommending contact lenses and glasses are not covered by Medicare. However, Medicare Part B may cover eye exams and tests for those with certain conditions, such as a yearly eye exam for diabetic retinopathy, high-risk retirees, and treatments for macular degeneration that are age-related. However, a simple vision test may be provided during your Welcome to Medicare visit.

You may also get some vision coverage through a Medicare Advantage Plan.

Hearing Aids

Medicare doesn’t cover hearing aids or tests needed to choose and fit the right hearing device. However, if your doctor determines that a hearing and balance exam is medically necessary, Medicare could cover it, but a deductible, copayment, and coinsurance may apply. Also, Medicare might pay for a surgically implanted hearing device.

You may also get some hearing coverage through a Medicare Advantage Plan.

To know more about what Medicare does or does not cover, contact Turning 65 Solutions to speak with an experienced Medicare expert.

Turning 65 Solutions can help you plan for the future.